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Lauren A. Smith, MD, MPH, Diana Romero, PhD, MA, Pamela R. Wood, MD, Nina S. Wampler, DSc, MPH, Wendy Chavkin, MD, MPH and Paul H. Wise, MD, MPH

Lauren A. Smith and Paul H. Wise are with the Department of Pediatrics, Boston University School of Medicine, Boston, Mass. Diana Romero and Wendy Chavkin are with the Heilbrunn Department of Population and Family Health, Mailman School of Public Health, Columbia University, New York City. Pamela R. Wood is with the Department of Pediatrics, University of Texas Health Science Center, San Antonio. Nina S. Wampler is with the Division of American Indian and Alaska Native Programs, University of Colorado Health Science Center, Denver.

Correspondence: Requests for reprints should be sent to Lauren A. Smith, MD, MPH, Boston Medical Center, Department of Pediatrics, Dowling 3 South, One Boston Medical Center Pl, Boston, MA 02118 (e-mail: lauren.smith{at}bmc.org).

Objectives. This study evaluated the association of chronic child illness with parental employment among individuals who have had contact with the welfare system.

Methods. Parents of children with chronic illnesses were interviewed.

Results. Current and former welfare recipients and welfare applicants were more likely than those with no contact with the welfare system to report that their children’s illnesses adversely affected their employment. Logistic regression analyses showed that current and former receipt of welfare, pending welfare application, and high rates of child health care use were predictors of unemployment.

Conclusions. Welfare recipients and applicants with chronically ill children face substantial barriers to employment, including high child health care use rates and missed work. The welfare reform reauthorization scheduled to occur later in 2002 should address the implications of chronic child illness for parental employment.

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